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Introduction
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January 2017 - May 2018
September 2013 - present
Publications
Publications (72)
Theoretical and empirical work suggests that stereotypes associated with mental health conditions automatically lead to stigmatizing attitudes toward individuals with mental health problems. However, the downstream path from stigma to social rejection may not be automatic: Certain factors may buffer the association between stigmatizing attitudes an...
Access to mental health support remains limited, particularly in marginalized communities where structural and cultural barriers hinder
timely care. This paper explores the potential of AI-enabled chatbots as a scalable solution, focusing on advanced large language models
(LLMs)—GPT v4, Mistral Large, and LLama V3.1—and assessing their ability to d...
Background
Instruments to assess the knowledge about the rights of persons with mental health conditions and psychosocial disabilities, the attitudes toward their role as rights holders, and mental health professionals’ practices related to substitute decision-making and coercion are either missing or lack evaluation of their validity and reliabili...
Women engaged in sex work (WESW) who use drugs are a key population in Kazakhstan’s HIV epidemic. Global research suggests susceptibility to HIV varies by sex work environment. This study aims to identify evidence-based typologies of WESW and examine their associations with HIV risk. We surveyed 400 WESW who use drugs in two Kazakhstani cities, inc...
Introduction
There is a research gap in how mental health and cognition are associated with antiretroviral treatment (ART) adherence among people living with HIV (PLWH) in Kazakhstan.
Methods
We randomly selected and enrolled 230 PLWH from the Almaty City AIDS Center registry (June−November 2019) into a cross‐sectional study. We examined associati...
Objective:
This study examines the relationships between HIV stigma dimensions, self-related mechanisms, and depressive symptoms among persons living with HIV.
Background:
HIV stigma hinders the well-being of individuals living with HIV, which is linked to depressive symptoms and increased risk of poor clinical outcomes. However, the mechanisms...
Women Living with HIV (WLHIV) who use substances face stigma related to HIV and substance use (SU). The relationship between the intersection of these stigmas and adherence to antiretroviral therapy (ART), as well as the underlying mechanisms, remains poorly understood. This study aimed to examine the association between intersectional HIV and SU s...
Women who exchange sex and use drugs (WESUD) are at high risk for HIV infection and partner violence. The few tested interventions at the intersection of HIV and IPV show mixed results. This analysis examined the impact of a combination HIV risk reduction (HIVRR) and microfinance (MF) intervention on reported paying and intimate partner violence ag...
Objectives
Healthcare personnel have faced unprecedented mental health challenges during the COVID-19 pandemic. The study objective is to assess differences in depression, anxiety, and burnout among healthcare personnel with various occupational roles and whether financial and job strain were associated with these mental health outcomes.
Methods
W...
Introduction
Punitive legal environments remain a challenge to HIV prevention efforts in Central Asia, and female sex workers who use drugs are vulnerable to police violence. Little is known about the heterogeneity of police violence against female sex workers who use drugs and factors associated with HIV risk in Central Asia, despite the growing H...
Objectives:
To explore the associations between intersectional poverty, HIV, gender, and racial stigma, adherence to antiretroviral therapy (ART), and viral suppression among women living with HIV (WLHIV).
Design:
We examined intersectional stigmas, self-report ART adherence, and viral suppression using cross-sectional data.
Methods:
Participa...
Our research explores the relationship between intersectional discrimination based on sexual orientation and HIV status and Cortisol Awakening Response among men who have sex with men (MSM) and live with HIV (LWH).
Introduction
Knowledge about sexual health is a key determinant of sexual behavior among adolescent sexual minority males (ASMM). No measures exist to assess anal sex knowledge, even though anal sex is the primary route by which ASMM acquire sexually transmitted infections (STIs), including a disproportionate burden of human immunodeficiency virus...
Importance
Female sex workers (FSWs) who use drugs face increased risk of intimate partner violence (IPV) and nonpartner violence (NPV). The association between violence and drug overdose is unknown.
Objective
To examine the association between IPV, NPV, and nonfatal drug overdose among FSWs who use drugs in Kazakhstan.
Design, Setting, and Parti...
Background
The United States’ opioid crisis disproportionately affects individuals in the criminal justice system. Intimate partners can be a source of social support that helps reduce substance use, or they can serve as a driver of continued or increased substance use. Better understanding of the association between intimate partner characteristic...
Objective:
To determine how psychiatric symptoms affect the self-efficacy of people with serious mental illness to protect themselves and their partners from HIV and other sexually transmitted infections (STIs) by using condoms.
Method:
As part of a National Institute of Mental Health-Funded study, people with serious mental illness (N = 467) we...
Background:
Intimate partner violence against women (IPV) and violence against children (VAC) are both global epidemics with long-term health consequences. The vast majority of research to date focuses on either IPV or VAC, however the intersections between these types of violence are a growing area of global attention. A significant need exists f...
Objective:
Human immunodeficiency virus (HIV) prevention efficacy trials with psychiatric patients have been conducted in research settings in high-resourced countries, establishing short-term efficacy for reducing sexual risk behavior. None has been implemented within systems of care. In the last decade, overcoming this research-to-practice gap ha...
Introduction:
Men who have sex with men (MSM) are suboptimally engaged in efficacious HIV interventions, due in part to stigma.
Aim:
We sought to validate the Anal Health Stigma Model, developed based on theory and prior qualitative data, by testing the magnitude of associations between measures of anal sex stigma and engagement in HIV preventio...
Diagnosis and treatment of acute HIV infection (AHI) is crucial for ending the HIV epidemic. Individuals with AHI, who have high viral loads and often are unaware of their infection, are more likely to transmit HIV to others than those with chronic infection. In preparation for an educational intervention on AHI in primary health care settings in h...
: Tremendous biomedical advancements in HIV prevention and treatment have led to aspirational efforts to end the HIV epidemic. However, this goal will not be achieved without addressing the significant mental health and substance use problems among people living with HIV (PLWH) and people vulnerable to acquiring HIV. These problems exacerbate the m...
For the initiated, college may be remembered as a care-free and playful time. However, for contemporary college students the transition to college is challenging with only 1 in 3 returning for their second year of study, and the challenges are even greater for first-generation and low-income students. The interactive digital platform of the current...
Background::
In sub-Saharan Africa, mental and substance-related disorders account for 19% of all years lived with disability, yet the intersection between poverty and mental distress is poorly understood since most psychiatric research is conducted in high-income countries.
Aims::
To examine the prevalence of and associations between food insec...
Objective:
Persons with mental illness have higher HIV infection rates than the general population. Little is known about whether care systems for this population are effectively participating in global efforts to end AIDS as a public health threat. This study examined treatment-as-usual HIV risk reduction services within public mental health sett...
The experience of sexual orientation stigma (e.g., homophobic discrimination and physical aggression) generates minority stress, a chronic form of psychosocial stress. Minority stress has been shown to have a negative effect on gay and bisexual men’s (GBM’s) mental and physical health, increasing the rates of depression, suicidal ideation, and HIV...
Background
Burnout is a multidimensional syndrome and includes symptoms of emotional exhaustion, depersonalization, and reduced personal accomplishment at work. Oncology health care providers are at high risk to develop symptoms of burnout because of work-related stressors. Adaptive coping strategies adopted to deal with stressors may prevent the d...
Haitians in the Dominican Republic (DR) are increasingly marginalized due to recent legislation that stripped Haitian-Dominicans of their citizenship and increased Haitian migrants’ deportation risk. Haitian female sex workers (FSWs) are particularly vulnerable, though little is known about them. This study will help public health efforts targeted...
Objective
We evaluated the psychometric properties of a new instrument “Mental Illness Sexual Stigma Questionnaire” (MISS-Q).
Methods
We interviewed 641 sexually active adults (ages 18-80) attending public outpatient psychiatric clinics in Rio de Janeiro about their stigma experiences.
Results
Nine factors were extracted through exploratory facto...
Resilience, commonly understood as the ability to maintain adaptive functioning in the face of adversity, has emerged as a salient entry point in the field of positive youth development. This study makes a unique contribution by exploring dimensions of resilience among adolescents in Uganda, examining associations between violence from different pe...
Tuberculosis (TB) and depression act synergistically via social, behavioral, and biological mechanisms to magnify the burden of disease. Clinical depression is a common, under-recognized, yet treatable condition that, if comorbid with TB, is associated with increased morbidity, mortality, community TB transmission, and drug resistance. Depression m...
Objective:
Associations between parental/caregiver depression and adverse child outcomes are well established and have been described through one or more mechanisms: child psychopathology following exposure to a depressed caregiver, child psychopathology exacerbating a caregiver’s depression, and caregiver and offspring depression sharing the same...
Background
Task shifting approaches (rational redistribution of tasks among health workforce teams) to train lay professionals to assist with integrating mental health treatment in primary care has been recommended to close the mental health treatment gap for depression in low- and middle-income countries. This study aims to examine the a new model...
While the physical health risks of sex work have been well documented, fewer studies have explored mental health risks associated with sex work. This study examined rates of depressive symptoms and associated risk factors among women engaged in sex work in Mongolia (n = 222), a country experiencing significant economic and social development and wh...
A confirmatory factor analysis of data from the responses of 12,436 patients to 16 items on the Consumer Assessment of Healthcare Providers and Systems–Hospital survey was used to test a latent factor structure based on Peplau’s middle-range theory of interpersonal relations. A two-factor model based on Peplau’s theory fit these data well, whereas...
The role of the serotonin transporter promoter-linked polymorphism (5-HTTLPR) in psychiatric disease remains unclear. Behavioral traits could serve as alternative outcomes that are stable, precede psychopathology, and capture more sub-clinical variation. We test associations between 5-HTTLPR and (1) behavioral traits and (2) clinical diagnoses of a...
AbstractAttitudes of Italian heterosexual men and women towards gay men, both HIV positive and negative, are poorly investigated. Italian culture is still extremely conservative, and provides limited support to the gay community e.g. lack of same-sex marriage recognition. Consequently, gay men experience social exclusion and disparities. The presen...
Background:
Women who engage in sex work are at risk for experiencing violence from numerous perpetrators, including paying partners. Empirical evidence has shown mixed results regarding the impact of participation in microfinance interventions on women's experiences of violence, with some studies demonstrating reductions in intimate partner viole...
The aim of the current study was to validate the Italian version of the Attitude Toward Personality Disorders Questionnaire (APDQ), assess its psychometric properties, and investigate nurses' attitudes toward patients with personality disorders. An Italian version of the APDQ was produced and administered to nurses working in the Bologna Mental Hea...
This study investigated whether self-compassion and emotional invalidation (perceiving others as indifferent to one's emotions) may explain the relationship of childhood exposure to adverse parenting and adult psychopathology in psychiatric outpatients (N =326). Path analysis was used to investigate associations between exposure to adverse parentin...
Self-report measures of affect come with a number of difficulties that can be circumvented by using indirect measurement procedures. The Implicit Positive and Negative Affect Test (IPANAT) is a recently developed measure of automatic activation of representations of affective states and traits that draws on participants’ ratings of the extent to wh...
Objective:
The majority of people in psychiatric care worldwide are sexually active, and studies have revealed sharply elevated rates of HIV infection in that group compared with the general population. Recovery-oriented treatment does not routinely address sexuality. We examined the relationship between gender, severe mental illness diagnosis, an...
Depressive symptoms cause major impairment and may accelerate HIV progression despite the use of antiretroviral medication. The somatic symptoms criteria for HIV infection and depression partially overlap, which can make differential diagnosis challenging. Because of chronic inflammation caused by HIV infection, HIV-positive patients may develop so...
Gay and bisexual men may experience stress due to their social minority status, which is caused by the manifestations of sexual stigma. Stress, in turn, promotes depression and physical health impairments, two major issues in the context of HIV infection. Thus, the relationships between the manifestations of sexual orientation stigma (enacted sexua...
Illness perceptions can influence the coping strategies used in response to HIV-related stressors, and ultimately patients’ clinical status. With this work, we aimed to: (1) identify illness perception-related profiles of HIV-positive patients; (2) evaluate the association between the profiles, illness-related coping strategies, HIV-progression bio...
Introduction:
Depression and cerebrovascular atherosclerosis often occur in comorbidity showing neuropsychological impairment and poor response to antidepressant treatment. Objective is to evaluate if new antidepressant vortioxetine may be a potential treatment option. Mechanism of Action : Vortioxetine has 5-HT3, 5-HT7 and 5-HT1D antagonists, 5-H...
HIV-positive individuals are at greater risk of depression, which is known to influence their well-being negatively. In fact, depression may promote unhealthy behaviors (e.g. drug use and intentional unprotected sex); furthermore, depression may also act reducing immune system functioning. However, the relationship between the immune system and dep...
HIV-positive individuals are at greater risk of depression, which is known to influence their well-being negatively. In fact, depression may promote unhealthy behaviors (e.g. drug use and intentional unprotected sex); furthermore, depression may also act reducing immune system functioning. However, the relationship between the immune system and dep...
Psychometric properties of the Group Environment Questionnaire were investigated in a large sample of soccer (n = 222) and professional basketball players (n = 375). Confirmatory factor analysis was performed both on the total sample and on the two subsamples through a multi-group approach; associations between cohesion and the duration of belongin...
This thesis is devoted to the study of psychological factors associated with HIV infection. It consists in three theoretical chapters and eight empirical studies. The first chapter illustrates the basis of psychoimmunology and the evidence about the connection between psychosocial factors and the immune system functioning. The second is a general i...
Rationale: Emotions have been associated with production of pro-inflammatory cytokines such as TNF-alpha and IL-6; more precisely, negative emotions with greater cytokines level whereas positive emotions with lower level of pro-inflammatory cytokines. This may have significant repercussions on individuals’ health specifically for those who are subj...
Aims
To validate the Italian version of the ‘depression attitude questionnaire’ (DAQ), to assess its psychometric properties and to evaluate the primary care physicians' (PCPs) opinion and attitude towards depression.
Methods
An Italian version of the DAQ was created and then administered to a representative sample of PCPs working in the Emilia-Ro...
Background: Recent studies have found that negative emotions promote a faster progression of HIV. Illness perception influences emotions, compliance and consequently illness progression. Method: Cross-sectional data were gathered via Internet. Participants were 146 people with HIV (gender: 84.2% M, 15.1% F; mean age = 40.22, SD=9.27). Self-report q...
Background: People with HIV daily cope with a chronic disease that requires a complex management. Antiretroviral treatments (highly active antiretroviral treatment, HAART) are effective in slowing HIV progression but it requests a strong compliance. Patients' depression along with negative emotions could affect compliance negatively and deserve att...
Il Difficulties in Emotion Regulation Scale (DERS) è uno dei test più usati per la valutazione
delle difficoltà nella regolazione emotiva per la popolazione adulta. La versione italiana è stata
somministrata a 190 persone e un sottogruppo (N = 81) ha compilato inoltre una batteria di test
paralleli. I risultati di un’analisi fattoriale confermat...
Diverse indagini hanno identificato delle differenze rispetto ai tratti di personalitŕ fra uomini eterosessuali, bisessuali e omosessuali. Inoltre, č stato riscontrato anche che in alcune culture come quelle mediterranee e latine č presente una forte associazione fra ruolo sessuale, orientamento sessuale e lo stereotipo legato alla dicotomia maschi...
The Difficulties in Emotion Regulation Scale (DERS) is one of the tests used most frequently to assess the difficulties in emotion regulation in the adult population. The Italian version of the DERS was applied to 190 adults, and in addition, a subgroup (81 adults) compiled a series of parallel tests. The results of a confirmatory factor analysis d...
The objective of the study is to investigate the benefits of joining a self-help group for patients with medication overuse headache (MOH). A self-help group is a voluntary gathering of a small number of persons who share a common problem. Little is known about support groups for people with chronic non-malignant pain such as MOH. Eight patients wi...
This study investigated the influence of homophobic school climate and gender on homophobia and prosocial behavior toward victims of homophobic aggression. Participants were 364 Italian high school students whose mean age was 17.96 (SD = 1.22). Structural equation modeling showed that male students tended to report more homophobia against both gays...
